title: Legumes and meat analogues consumption are associated with hip fracture risk independently of meat intake among Caucasian men and women: the Adventist Health Study-2.
abstract: OBJECTIVE
  In contrast to non-vegetarians, vegetarians consume more legumes and meat analogues as sources of protein to substitute for meat intake. The present study aimed to assess the association between foods with high protein content (legumes, meat, meat analogues) by dietary pattern (vegetarians, non-vegetarians) and hip fracture incidence, adjusted for selected lifestyle factors.
  
  
  METHODS
  A prospective cohort of Adventist Health Study-2 (AHS-2) enrollees who completed a comprehensive lifestyle and dietary questionnaire between 2002 and 2007.
  
  
  METHODS
  Every two years after enrolment, a short questionnaire on hospitalizations and selected disease outcomes including hip fractures was sent to these members.
  
  
  METHODS
  Respondents (n 33,208) to a baseline and a follow-up questionnaire.
  
  
  RESULTS
  In a multivariable model, legumes intake of once daily or more reduced the risk of hip fracture by 64% (hazard ratio = 0·36, 95% CI 0·21, 0·61) compared with those with legumes intake of less than once weekly. Similarly, meat intake of four or more times weekly was associated with a 40% reduced risk of hip fracture (hazard ratio = 0·60, 95% CI 0·41, 0·87) compared with those whose meat intake was less than once weekly. Furthermore, consumption of meat analogues once daily or more was associated with a 49 % reduced risk of hip fracture (hazard ratio = 0·51, 95% CI 0·27, 0·98) compared with an intake of less than once weekly.
  
  
  CONCLUSIONS
  Hip fracture incidence was inversely associated with legumes intake and, to a lesser extent, meat intake, after accounting for other food groups and important covariates. Similarly, a high intake of meat analogues was associated with a significantly reduced risk of hip fracture.
authors.affiliation: 1Department of Health Services,Los Angeles County,CA,USA.
authors.forename: Vichuda
authors.initials: V
authors.lastname: Lousuebsakul-Matthews
authors.affiliation: 3Department of Physical Therapy,School of Allied Health Professions,Loma Linda University,Loma Linda,CA,USA.
authors.forename: Donna L
authors.initials: DL
authors.lastname: Thorpe
authors.affiliation: 2Department of Epidemiology & Biostatistics,School of Public Health,Loma Linda University,Loma Linda,CA 92350,USA.
authors.forename: Raymond
authors.initials: R
authors.lastname: Knutsen
authors.affiliation: 2Department of Epidemiology & Biostatistics,School of Public Health,Loma Linda University,Loma Linda,CA 92350,USA.
authors.forename: W Larry
authors.initials: WL
authors.lastname: Beeson
authors.affiliation: 2Department of Epidemiology & Biostatistics,School of Public Health,Loma Linda University,Loma Linda,CA 92350,USA.
authors.forename: Gary E
authors.initials: GE
authors.lastname: Fraser
authors.affiliation: 2Department of Epidemiology & Biostatistics,School of Public Health,Loma Linda University,Loma Linda,CA 92350,USA.
authors.forename: Synnove F
authors.initials: SF
authors.lastname: Knutsen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002140:California / Q000453:epidemiology; D015331:Cohort Studies; D014676:Diet, Vegetarian; D004044:Dietary Proteins / Q000627:therapeutic use*; D007887:Fabaceae; D005260:Female; D005500:Follow-Up Studies; D006620:Hip Fractures / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D008019:Life Style; D008297:Male; D008460:Meat / Q000009:adverse effects; D008875:Middle Aged; D009749:Nutrition Surveys; D016016:Proportional Hazards Models; D011446:Prospective Studies; D033303:Protestantism; D012639:Seeds
chemical_list: D004044:Dietary Proteins